Quality of life outcomes in patients with obsessive-compulsive disorder: Relationship to treatment response and symptom relapse

Eric Hollander, Dan J. Stein, Naomi A. Fineberg, Florence Marteau, Mark Legault

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Objective: Data were analyzed from 2 prospective, double-blind, placebo-controlled trials of escitalopram in obsessive-compulsive disorder (OCD) to characterize the baseline levels of functional disability and impairment in health-related quality of life (HRQoL) and to assess the relationship between treatment outcomes (response or relapse) and disability or HRQoL. Method: Data from a 24-week, placebocontrolled, fixed-dose trial (N = 466) of escitalopram (10-20 mg/d) or paroxetine (40 mg/d) and from a 40-week, flexible-dose (escitalopram 10-20 mg/d), placebo-controlled relapse-prevention trial (N = 468) were analyzed. Obsessive-compulsive disorder symptoms (DSM-IV criteria) were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), functioning was assessed using the Sheehan Disability Scale (SDS), and HRQoL was assessed using the Medical Outcomes Study Short Form (SF-36). Baseline data were pooled for patients across both studies. For patients in the fixed-dose study, SDS and SF-36 scores were compared across treatment groups and for responders versus nonresponders. In the relapse-prevention trial, SDS and SF-36 scores were compared for relapsed versus nonrelapsed patients. Results: Patients with more severe baseline symptoms (YBOCS ≥ 27) reported significantly greater impairment on the SDS (P <.001) and SF-36 (except for bodily pain). Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions and on the SDS compared to placebo; however, improvements in work-related functioning were seen earlier for patients receiving escitalopram (20 mg/d). At the study endpoints, SDS and SF-36 scores were significantly better for patients who were responders (versus nonresponders) and for patients who did not relapse (versus relapsers). Conclusions: Obsessive-compulsive disorder is associated with significant impairment in functioning and HRQoL. Significant differences in disability and HRQoL between responders and non-responders or relapsers and nonrelapsers suggest a relationship between symptomatic and functional outcomes. Trial Registration: lundbecktrials.com Identifiers: 10205 and 10193.

Original languageEnglish (US)
Pages (from-to)784-792
Number of pages9
JournalJournal of Clinical Psychiatry
Volume71
Issue number6
DOIs
StatePublished - Jun 2010

Fingerprint

Obsessive-Compulsive Disorder
Citalopram
Quality of Life
Recurrence
Paroxetine
Placebos
Therapeutics
Secondary Prevention
Diagnostic and Statistical Manual of Mental Disorders
Outcome Assessment (Health Care)
Pain

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Quality of life outcomes in patients with obsessive-compulsive disorder : Relationship to treatment response and symptom relapse. / Hollander, Eric; Stein, Dan J.; Fineberg, Naomi A.; Marteau, Florence; Legault, Mark.

In: Journal of Clinical Psychiatry, Vol. 71, No. 6, 06.2010, p. 784-792.

Research output: Contribution to journalArticle

Hollander, Eric ; Stein, Dan J. ; Fineberg, Naomi A. ; Marteau, Florence ; Legault, Mark. / Quality of life outcomes in patients with obsessive-compulsive disorder : Relationship to treatment response and symptom relapse. In: Journal of Clinical Psychiatry. 2010 ; Vol. 71, No. 6. pp. 784-792.
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abstract = "Objective: Data were analyzed from 2 prospective, double-blind, placebo-controlled trials of escitalopram in obsessive-compulsive disorder (OCD) to characterize the baseline levels of functional disability and impairment in health-related quality of life (HRQoL) and to assess the relationship between treatment outcomes (response or relapse) and disability or HRQoL. Method: Data from a 24-week, placebocontrolled, fixed-dose trial (N = 466) of escitalopram (10-20 mg/d) or paroxetine (40 mg/d) and from a 40-week, flexible-dose (escitalopram 10-20 mg/d), placebo-controlled relapse-prevention trial (N = 468) were analyzed. Obsessive-compulsive disorder symptoms (DSM-IV criteria) were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), functioning was assessed using the Sheehan Disability Scale (SDS), and HRQoL was assessed using the Medical Outcomes Study Short Form (SF-36). Baseline data were pooled for patients across both studies. For patients in the fixed-dose study, SDS and SF-36 scores were compared across treatment groups and for responders versus nonresponders. In the relapse-prevention trial, SDS and SF-36 scores were compared for relapsed versus nonrelapsed patients. Results: Patients with more severe baseline symptoms (YBOCS ≥ 27) reported significantly greater impairment on the SDS (P <.001) and SF-36 (except for bodily pain). Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions and on the SDS compared to placebo; however, improvements in work-related functioning were seen earlier for patients receiving escitalopram (20 mg/d). At the study endpoints, SDS and SF-36 scores were significantly better for patients who were responders (versus nonresponders) and for patients who did not relapse (versus relapsers). Conclusions: Obsessive-compulsive disorder is associated with significant impairment in functioning and HRQoL. Significant differences in disability and HRQoL between responders and non-responders or relapsers and nonrelapsers suggest a relationship between symptomatic and functional outcomes. Trial Registration: lundbecktrials.com Identifiers: 10205 and 10193.",
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AU - Stein, Dan J.

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AU - Marteau, Florence

AU - Legault, Mark

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N2 - Objective: Data were analyzed from 2 prospective, double-blind, placebo-controlled trials of escitalopram in obsessive-compulsive disorder (OCD) to characterize the baseline levels of functional disability and impairment in health-related quality of life (HRQoL) and to assess the relationship between treatment outcomes (response or relapse) and disability or HRQoL. Method: Data from a 24-week, placebocontrolled, fixed-dose trial (N = 466) of escitalopram (10-20 mg/d) or paroxetine (40 mg/d) and from a 40-week, flexible-dose (escitalopram 10-20 mg/d), placebo-controlled relapse-prevention trial (N = 468) were analyzed. Obsessive-compulsive disorder symptoms (DSM-IV criteria) were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), functioning was assessed using the Sheehan Disability Scale (SDS), and HRQoL was assessed using the Medical Outcomes Study Short Form (SF-36). Baseline data were pooled for patients across both studies. For patients in the fixed-dose study, SDS and SF-36 scores were compared across treatment groups and for responders versus nonresponders. In the relapse-prevention trial, SDS and SF-36 scores were compared for relapsed versus nonrelapsed patients. Results: Patients with more severe baseline symptoms (YBOCS ≥ 27) reported significantly greater impairment on the SDS (P <.001) and SF-36 (except for bodily pain). Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions and on the SDS compared to placebo; however, improvements in work-related functioning were seen earlier for patients receiving escitalopram (20 mg/d). At the study endpoints, SDS and SF-36 scores were significantly better for patients who were responders (versus nonresponders) and for patients who did not relapse (versus relapsers). Conclusions: Obsessive-compulsive disorder is associated with significant impairment in functioning and HRQoL. Significant differences in disability and HRQoL between responders and non-responders or relapsers and nonrelapsers suggest a relationship between symptomatic and functional outcomes. Trial Registration: lundbecktrials.com Identifiers: 10205 and 10193.

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